Alberti W, Katsilieris I, Schulz U, Callies R
Strahlenther Onkol. 1986 Aug;162(8):488-95.
Between 1968 and 1979, 132 patients with squamous cell carcinomas of the vulva were submitted to a more or less radical operation. Then they were irradiated at the Radiologic Center of the GHS Essen. All patients received irradiations of the vulvar region with high energy electrons combined with photons (n = 78) as well as photons or electrons alone (n = 15 and 39, respectively). The dose was generally 40 to 60 Gy. 81 patients (61.4%) were additionally irradiated in the inguinal region. The overall three-year and five-year survival rate is 48.5 and 34.1%, respectively. The median survival time is 31.5 months. Contrary to expectation there were no significantly different recurrence rates after radical vulvectomy and large excision combined with postoperative irradiation. This is attributed to the favorable effect of radiotherapy. A graduated conception has been elaborated based on the results of our retrospective analysis and the communications of literature. Radical vulvectomy and inguinal lymphadenectomy is the therapy of choice. Radiotherapy in the vulvar region should be applied if radical surgery seems problematic or is not possible. Irradiation of lymph node regions is indicated if they are involved or if a resection is not possible.
1968年至1979年间,132例外阴鳞状细胞癌患者接受了或多或少的根治性手术。随后,他们在埃森GHS放射中心接受放疗。所有患者均接受了高能电子与光子联合照射外阴区域(n = 78)以及单独使用光子或电子照射(分别为n = 15和39)。剂量一般为40至60 Gy。81例患者(61.4%)腹股沟区域也接受了额外照射。总体三年和五年生存率分别为48.5%和34.1%。中位生存时间为31.5个月。与预期相反,根治性外阴切除术和广泛切除联合术后放疗后的复发率没有显著差异。这归因于放疗的良好效果。基于我们的回顾性分析结果和文献报道,已经制定了一个分级概念。根治性外阴切除术和腹股沟淋巴结清扫术是首选治疗方法。如果根治性手术似乎有问题或无法进行,则应在外阴区域进行放疗。如果淋巴结区域受累或无法切除,则应进行淋巴结区域照射。